An opportunity to be heard

-Lester Liao

The recent policy draft of the CPSO that obligates physicians to refer for procedures they disagree with has given us an opportunity to voice or concerns. We cannot live under the illusion anymore that we face no persecution in Canada as Christians. We have to be bold and stand for what we believe and articulate it well. I urge you to make even a small feedback comment on the CPSO site at http://policyconsult.cpso.on.ca/?page_id=5165. Urge others to do this as well. Get in touch with your churches and the elders and get the whole body involved in this issue. Ask them to pray, and ask them to provide feedback. Be earnest and persevere in this.

We cannot go at this alone and we cannot do nothing anymore.

Lord willing this draft will be revised. Below you will find my own letter that I plan to send. I have put it here for your reference in case you find it helpful in articulating your own thoughts or care to pass it on to others.

Dear College of Physicians and Surgeons of Ontario,

I am a third year medical student in Ontario. Thank you for the work that has gone into drafting the latest policy on Professional Obligations and Human Rights. I recognize that this is a difficult task to be able to protect the rights of all. That being said, I would like to raise a few of my concerns. 

Firstly, I think it is important to define what religious beliefs are. Are religious beliefs those that are related to beliefs in a supernatural power or something else? We must clarify this because every single one of us has moral and religious beliefs. We all believe things about the meaning of life, what makes life valuable, and so on. These are not based on science but are metaphysical questions based on a worldview. We all espouse a worldview, whether it is theistic, deistic, agnostic, or atheistic, and all of our answers to these questions are based on these worldviews or religions. To exclude "religious" views based on some sort of worldview tradition would mean we must exclude how every one of us understands these life questions unanswerable by empirical science. This would prevent us from being people with thoughts, hopes, and any beliefs. In this sense we are all religious people. 

Additionally, every physician has a moral code based on a worldview that he/she then practices with. The decision to help a patient's health is in itself morally charged.  Why should a physician help? No scientific experiment obligates you to help someone - it only tells you what will likely happen if you for example give a certain drug. The decision to help is based on a moral belief that it is good to help others. Every physician has moral beliefs that necessarily play a massive part in his/her clinical practice. The current policy draft to exclude certain moral beliefs is problematic for three reasons: it fragments the humanity of the practitioner, it is logically and practically impossible to exclude moral beliefs from practice, and it presupposes that these moral beliefs are wrong without actually demonstrating so. I will tackle these in turn. 

Firstly, when we decide as a profession that we will force physicians to act against their moral beliefs, we are throwing moral integrity to the wind. We ask our physicians not to have moral integrity but to do what they are told, and it is extremely dangerous to force physicians to do something they believe to be wrong. This fragments who we are fundamentally as people with consciences. This means in essence saying we want slaves to perform our will, not free people working. This is a form of coercion and disregards the rights of the physician as an autonomous person him/herself. For the policy must take into account the humanity of both patient and doctor.

Secondly, we cannot ask physicians to be amoral because the decision to help people is itself moral, and the decision to be amoral is also itself a moral choice. In other words, any decision to be moral or amoral is impossible to exclude from practice logically because the decision is itself a moral one. Moral beliefs are also not a category that we can separate because they are at the heart of why we practice medicine and so we cannot exclude them practically. Do we ask a physician to leave their morals out of medicine, including their moral code to help people, be just, respect patients, and do no harm? No. This would be an absurd thing to do. This notion of keeping moral beliefs outside of practice is not coherent and is actually undesirable. This policy is imposing its beliefs on physicians, which goes against its very own moral stance to not promote one’s own religious/moral beliefs.   

This leads to the third point. If we begin to choose what moral beliefs can or cannot be excluded, we are in fact making moral judgments on whether those moral beliefs are correct or incorrect. To say that they must be excluded presupposes that these beliefs are wrong. We do not tell physicians to leave out their beliefs of helping people because they are believed to be right. If we exclude other beliefs, we automatically presuppose they are wrong. This policy as it stands already assumes these physicians are wrong but does not justify this position with reasons, and ironically it makes a moral conclusion it prohibits practitioners from making. Hence we cannot say that a physician is obligated to refer for a procedure he/she is unwilling to perform based on the grounds that his/her beliefs are simply "moral" or "religious."  

In a similar vein, the distinction between personal and clinical beliefs is unclear. Everyone that answers ethical questions in medicine draws from his/her worldview, which means ultimately these answers are personal for everyone. For example, whether you desire or do not desire to perform abortions is based on your moral outlook that it is either good or bad to do them, which is a personal matter based on worldview. Any decision made clinically is a personal matter. 

Once again I must express sincerely that I appreciate the work that has gone into this draft. This is a laborious process and I am grateful for the feedback process. However, I am afraid of the implications of what this means for physicians in Ontario and the province I hope to practice in. Are we moving to a place where we impose our beliefs on physicians to do things? Can we see ourselves in the future as a province stripping physicians of licenses because despite competently caring for thousands of patients they refuse to refer one based on non-malicious intent? And can we even justify these claims when all parties involved have arguments that are morally and religiously driven from worldviews?

Thank you for taking the time to read this and for carefully considering this letter.

Sincerely, 

Lester

What's in FOCUS?

FOCUS is CMDS Canada's publication covering topics that are important to the Christian medical and dental community. It's a great way to connect with colleagues, get the latest views and news on faith and practice, as well as find interesting and thought provoking essays and articles.

If you're not already subscribed, you can find past subscriptions here on our website or email our office to start your new subscription by mail.

Finding Light

-by Lester Liao

What does it mean to be light (Mt 5:14-16)? Undoubtedly there are many facets to this question, but Jesus does make clear that light is something that is seen and noticeable. It illuminates a house as a lamp put on a stand. Naturally as I considered Jesus’ words, I asked myself – am I shining?

There are many ways to be light in the medical setting. We can work well and glorify God (Col 3:23). We can influence our workplace with godly conduct and care for those who are sick. The list continues. But there is one aspect of light that I had previously given little thought before I hit the hospitals. Jesus addresses his disciples in the Sermon on the Mount (Mt 5:1-2). He says that they are the light of the world. In thinking about how to be bright, I overlooked that somewhere in the workplace there could already be light! And certainly several lights together shine brighter than any light alone.

When I began clerkship, I had my radar on. After a brief comment from one of my preceptors about a mission trip, I was prompted to ask. Turns out he is a Christian, and we shared some wonderful conversation afterwards. I gave him a copy of FOCUS and a book on worldviews. Over our continued time together, we also had the chance to sit down with a patient’s Christian mother and discuss the importance of her daughter’s spiritual health in her physical health. This physician encouraged me.

Over the following month and a half I encountered two more Christian physicians, both of whom I learned of by inquiring. Helpful words were exchanged. I also asked one of my preceptors that I learned did not perform abortions if he was Christian. He is not, but that conversation has prompted a yet-to-be-scheduled dinner over which we can talk about religion.

These are simply to point out that paying attention to where light shines is helpful. Often with the busyness I get caught up in the medicine and lose perspective. But I was surprised to learn that there are more brothers and sisters out there than I suspected, and forming relationships with them has been instrumental in helping me remember what I am doing in Christ. Especially in a time when faith is being pushed out of the public square, it is important to encourage one another. We were never intended to walk our lives of faith alone but to stir one another up to love and good works (Hb 10:24-25). And not surprisingly, other Christian physicians are particularly aware of the challenges we face, and the value of generational wisdom transmission cannot be overstated (Ti 2:1-6). Furthermore, as we begin to identify with one another in a public way, we can show how our faith positively impacts our practices and we can stand together when adversity comes (Ecc 4:12).

My hope is that we can find one another so that we can do life well as family. We can encourage each other to live well for Christ. We need one another. May God help us to come together and so be a brighter light in the medical world.

Upcoming Event: Nov. 6, 2014

Dr. John Patrick lectures throughout the world working for the Christian Medical and Dental Society in Canada and the Christian Medical and Dental Association in the United States. He speaks frequently to Christian and secular groups and is able to communicate effectively on moral issues in medicine and culture and the integration of faith and science.

We're pleased to announce this free, online lecture with Dr. Patrick on the topic of Conscience Rights. 

Go to: https://www.anymeeting.com/532-168-512?rslt=6c3fed29-4e5d-440a-8061-eb8e03e842d7

We encourage all CMDS members, students and staff to attend. You can join by computer, wireless device, or phone.

CMDS Canada Presents: Dr. John Patrick on Conscience Rights
Thursday, November 06, 2014
12:00 PM - 1:00 PM Eastern Time

You can choose to hear the audio for this meeting either through your computer speakers or by dialing the following conference call information with your phone:

Dial-in Number: 213-416-1560 | Attendee PIN: 397 2989#

Copy the following URL into your browser to attend:
https://www.anymeeting.com/532-168-512?rslt=6c3fed29-4e5d-440a-8061-eb8e03e842d7

CMDS welcomes our new Associate Staff member in Ottawa!

CMDS Canada is pleased to announce that Ben Jolliffe has accepted the position of Associate staff for CMDS in Ottawa.

Ben is an ordained minister in the Presbyterian Church and is eager to get started in serving the CMDS group at University of Ottawa. He has a background in campus ministry and a distinct interest in helping people integrate their faith and vocation.

If you would like more information about CMDS at the University of Ottawa, please contact Ben Jolliffe at: ben@resurrectionchurch.ca

Welcome to our new Associate Staff!

CMDS Canada is pleased to announce that Jon Dykeman has accepted the position of Associate staff for CMDS at the University of Toronto.

Jon is currently a part-time youth pastor at Christ Church St. James in Etobicoke. This role has included ministering to youth and young adults in the parish aged 12 - 35. He leads weekly devotionals and bible studies, preaches, organizes special events and retreats and provides pastoral care to individuals. He recently completed his last course in his MDiv from Wycliffe College in "Pioneering Ministries" - which  provided an emphasis on mission and evangelization. Jon also holds a BA in religious studies from Memorial University in St. John's. He has had a lot of experience in youth work, dating back to his undergraduate years.

Jon has a great interest in supporting medical and dental students in the integration of their Christian faith and medical training and practice.

Jon will be available for the Sept 9th meeting with students and will be able to attend our three day conference for Associate Staff across the country on October 14-16th in Toronto.

CMDS would ask that student leaders to get in touch with Jon right away to get him involved with the exciting activities you have in mind. Email him here.

Will health care be around for the baby boomers?

-by Jennifer Derwey

As people age, health care and prescriptions can become a large part of their concerns and their monthly costs. A poll from the Canadian Medical Association shows that,

The survey of Canadians aged 45-plus shows that 78 per cent of them are worried that they will not be able to access necessary health services like homecare and long-term care in a timely fashion when they need them.

Will these fears be realized by funding cuts to health care in Canada? And if so, will it impact Canadian legislation on euthanasia if health care becomes less accessible for our aging population? 

Long term and home care are a vital part of the Canadian health care system, and access to these services must be maintained and even improved if we are going to continue to provide quality health care to Canadians. 

A ranking by the World Health Organization in 2000 placed Canada 30th in terms of their health care system, and yet Canada came 10th in expenditure per capita. 

(source: http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000)

"CMDA physicians: Dr. Kent Brantly is not a hero. He is living the normal Christian life."

From the CMDA,

Bristol, TN,  August 4, 2014--The Christian Medical & Dental Associations (CMDA), the nation's largest faith-based association of healthcare professionals, today issued the following statement on the controversy surrounding bringing Dr. Kent Brantly and Nancy Writebol, both suffering from Ebola, back to the U.S. for treatment.
"As a physician who has dealt with deadly epidemics in Africa where I served as a missionary and then as the first medical director for Samaritan's Purse, the risk of causing an Ebola epidemic by transporting these missionaries to the U.S. is so close to zero that it is incalculable," noted CMDA CEO Dr. David Stevens. "Unlike bird flu and other dangerous viruses, Ebola requires direct contact with bodily fluids from a patient to transmit the virus. It is not passed by coughing or casual contact, and every precaution has taken place."
Kent Brantly has been a member of CMDA since he started medical school where he was a dynamic student leader. He had a call to healthcare missions from a young age and participated in many short-term mission trips overseas. Last year at this time, he was at CMDA's headquarters in Bristol, Tennessee where Dr. Stevens and other staff helped train Dr. Brantly, his wife Amber and a group of other young professionals who were preparing to serve as new missionaries with Samaritan's Purse.

"Kent has been called a 'hero.' Of course he is in the sense of having courage and great strength of character, but he would tell you that he is just living the 'normal Christian life' that every Christian should live. He is simply a Christian disciple 'denying himself, taking up his cross and following Jesus' as Christians have done for millenniums (Matthew 16:24). He is simply laying down his life for others as Christ laid down his life for him," said Dr. Stevens.
Stevens, who personally dealt with the outbreak of AIDS in Africa and wiped out an epidemic of relapsing fever in Sudan, added, "Last week we trained 20 more young healthcare professionals and their spouses who are going all over the world to serve as missionaries. Two of them are going to the same hospital in Liberia where Kent and Nancy were infected. I challenged them saying, 'You will not live in fear of disease, suffering and even death if you die to self before you go.' That is not extraordinary; it's the normal Christian life that every Christian should live."

Dr. Stevens joined Karl and June on Moody Radio Chicago on Monday, August 4 to discuss this topic and help explain the low risk of the spread of Ebola in the U.S. You can listen to his live interview at www.cmda.org/ebola. To schedule an interview with Dr. Stevens, please contact VP for Communications Margie Shealy at communications@cmda.org or 423-844-1047. For more information about CMDA, please visit www.cmda.org.

Dr. Paul Saba to fight euthanasia in court

From Ville Marie Online,

Written by Deborah Rankin for VMO
Friday, July 18th, 2014
Dr. Paul J. Saba, a Quebec family physician who filed a lawsuit against Quebec's 'right-to-die legislation' in May along with co-plaintiff Lisa D'Amico, a handicapped person, is due to appear in Montréal Superior Court next week to discuss preliminary issues regarding the case, according to his lawyer Dominique Talarico.
The President of the Coalition of Physicians for Social Justice is warning parents that if the law isn't overturned, euthanasia will likely be extended to children and people with mental health problems, as is  already the case in Belgium and the Netherlands.
Noting that the Quebec Human Rights Commission has recommended that the controversial practice be extended  to minors, as well as vulnerable adults who are not apt to give informed-consent, Saba said that many "innocent persons" will die needlessly because of errors in diagnosis, poor prognosis, and lack of access to palliative care and adequate social services. In the case of an emancipated minor of 14 years of age or older, they could petition the courts to end their life, arguing that the current regime of "medical aid in dying" is discriminatory.
Dr. Saba said that the Quebec Government has turned a "deaf ear" to rational arguments in favor of a pre-determined agenda. "Euthanasia is not medical treatment," he stressed. "The Québec Government does not have the right to legislate euthanasia as a medical practice.
Euthanasia is against all the laws of this province and this country." 

Read the article in full here: http://www.villemarieonline.com/paul-saba-to-fight-euthanasia-in-court

New chairs bring smiles

Original Article by Melanie Tucker | melt@thedailytimes.com |

An extra special donation to Trinity Dental Clinic in Maryville has the entire office smiling.
Last week, the nonprofit, nondenominational Christian ministry that provides dental care for those who are uninsured or under-served, was the recipient of two state-of-the-art dental chairs, thanks to a grant from Delta Dental of Tennessee. The chairs, which were made in Italy, are the first of their kind to be installed here in the U.S.
Philip Grace and Greg McCarter of Dental and Technology Specialists, did the installation.
The chairs these replaced were 30 years old, said Benalee Hutsell, office manager at Trinity. There are still two more of those antiquated chairs in use. 

(source: http://www.thedailytimes.com/community/trinity-dental-receives-grant-for-new-chairs/article_c93d9bfc-6a9f-5b3e-96f0-2557822f135f.html)

Thank You: Dr. Robert Patton

Dr. Robert Patton 

Bob is a pediatric dentist in Vancouver. Bob treats those children who for one reason or another who are not able to go to a regular dentist. He has provided a lifetime of service to CMDS Canada. He has served on the national board for over 40 years. He has also served as President of the Vancouver Chapter for many years. The weekend of the CMDS National Conference, Bob formally resigned from the Board. CMDS Canada thanks Bob for his years of faithful service. We will really miss his wisdom and sense of humor.
God bless you Bob for your generous gift of yourself.

*Watch for an article on Dr. Robert Patton in the next edition of the CMDS Canada magazine, Focus.

Action Item

Protect the human rights of physicians. Vote "Yes!" in the poll, and give your input on the Physicians and the Ontario Human Rights Code policy currently under review here: http://policyconsult.cpso.on.ca/?page_id=3403

Physicians and the Ontario Human Rights Code | CPSO

policyconsult.cpso.on.ca

Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?

Improving palliative care, a solution for all

Father Raymond J. de Souza writes in the National Post,

There are increasing numbers of those among us who are frail and ill, growing weaker under the burden of disease or years. How will our public policy and common culture respond? The Angus motion recognizes that many Canadians do not desire heavily medicalized final weeks or months, but a more personal preparation for death, preferably accompanied by their loved ones at home.

Our health care system does not provide such alternatives readily. It is designed to make expensive, invasive treatments accessible. So it does, forcing many at the end of life to endure treatments that are unduly burdensome in circumstances that are often impersonal. Palliative care for the dying seeks to treat pain and discomfort, but to allow, as much as possible, a preparation for death that respects the dignity of the person and those close to him.

The lack of adequate palliative care across the country is a failure of our health care system to respond to actual patient needs.

(Read the full article here: http://fullcomment.nationalpost.com/2014/05/28/raymond-j-de-souza-instead-of-legalizing-euthanasia-try-improving-canadian-palliative-care/)

"The Vocation of Medicine: Considering History, Theology, and Sociology"

From Lester Liao at the CMAJ Student Humanities Blog,

When we enter medicine solely for personal fulfillment, everything becomes a means to that end. Patients are welcome insofar as we can bill for them or insofar as they present us with cases that can further our academic careers. But when we are not paid more for dealing carefully with patients’ concerns, they become a nuisance. We usher them out because their questions do not benefit us. Unless some prestigious publication is attached to our caregiving, these patients are not worth our time. It upsets me to consider friends who have been poorly treated by the “best” or “most prestigious” physicians in a field. We do not see them as people in need of help, nor do we see ourselves as public servants. We see patients as secondary, or even as obstacles to our primary goals. If we think like this, we will be uncaring doctors. 

(Read the full article here: http://cmajblogs.com/the-vocation-of-medicine-considering-history-theology-and-sociology/)

Upcoming Event: May 23, 2014

23rd of May

Student Lunch with Larry Worthen CMDS Executive Director
Western University

On Friday, May 24th Larry Worthen, CMDS Executive Director will be having lunch with students and Munjula Saito, CMDS Associate Staff at the Wave (2nd floor UCC building) at Western University. (11:30 - 11:45 start) After lunch all are welcome to come and hear Larry's talk at Brescia College at 13:30
"Is there a role for Christianity in the Euthanasia Debate?"

Dr. Bryan Dias who is the President of the Canadian Federation of Catholic Physicians Societies (CFCPS) has offered a warm welcome to any students who would like to come hear Larry's talk.

Larry is in town to give his talk and participate in the 6th annual national conference for the CFCPS.

Everyone is welcome!

The #CMDS2014 National Conference Experience

-by Lester Liao

This weekend I attended the National Conference for CMDS.  It was amazing.

Despite the low attendance of students/residents (less than 10), the experience was incredible.  What a wonderful opportunity it was to meet other physicians that have been in the practice of serving Christ in medicine for decades!  What wisdom there was to be distilled from brilliant minds!  What fun it was to praise Jesus and learn together!

I must say this was one of the best, if not best, conference I have ever attended. A large part of this is likely because it was my first real exposure to the CMDS community at large. Our student CMDS chapter in Windsor is small, and there is only one full-fledged CMDS physician actively involved with us.  Yet at this conference there were so many people to meet.  My vision for the work and influence of Christian physicians in CMDS grew exponentially.  It was massively encouraging.  For the first time I met Dr. John Patrick, who blew my mind away (and my fellow Windsor student’s) after just a few minutes of conversation with his sharp insights and apologetic method.  I attended seminars that were both educational and spiritually enriching, addressing issues that have never been brought up in medical school.  The PAS/euthanasia presentation was poignant and eye-opening, and has compelled me to share this message with local churches and colleagues.  I had numerous extended conversations (some over two hours!) wise people that really challenged my thinking and simultaneously built me up – all outside of the formal schedule. And the list continues.  I quite distinctly recall the feeling of my head swelling over the weekend because of everything I was taking in. I have never been at a conference like this one.

What I learned also encouraged me in practical engagement in my setting. Just the day after the conference ended I was able to talk to one of my preceptors about euthanasia/PAS with some of what I had learned, only to find out he is an influential policy maker at the hospital!  This very morning I spoke with colleagues in small group about the need for us to consider why we do medicine and not simply how we do it – and some very good discussion ensued.  By the end of the conversation one colleague even admitted to the fear of what her own thoughts would lead to practically, and she then desired to change her stance.

What a blessing it is to be part of this organization. It is my prayer that more students would become involved at a level beyond the student level. The mutual encouragement of different generations kindles fire for Christ in our souls. CMDS is a wonderful place where we can help one another in our respective fields and spur one another on to love and good works. Let’s hope that more students and residents can get connected with the community at large so that we can learn from one another, come together, and magnify Christ in healthcare.  

"My thoughts on Euthanasia"

-by DENNIS W. BOETTGER MD

My thoughts on Euthanasia, (aka end of life care)

The Governmental regulation of trust-based institutions (banks, credit unions etc.) creates an environment that engenders trust in the institution. We deposit monies and expect accurate accounting, access and protection of the assets we grant to the bank in safekeeping.

Medical care is based on trust.  A patient engages a physician to provide expert opinion, and upon the patient’s authorization in trust, the physician is allowed the authority to provide ongoing advice and recommended management of the life entrusted to the physician.

The physician is accountable to administer best practices, and failure to do that is considered a breech of trust, and if harm can be proven, then the practitioner is held accountable.

This principle is one of the most foundational principles of the practice of medicine.

Life itself, is entrusted to us. It is granted to the infant. Passed on from the parent, this life is life that was received from the grand-parents.

We are taught to steward our life well, because it is granted to us for a season, and then we must release it.

I contend that DNA is an elegant accounting system of the stewardship of life. In DNA is traceable the lineage, and is a stewardship record of the life granted in the transfer of DNA.

Do we “own” the life that we individually carry for a season? We certainly have authority to direct our own life, to a limited extent. If we direct our life in such a way as that it brings harm to others, our freedom to direct our life may be removed from us. This is what happens when prison accommodation is imposed upon a person for a punishable breach of trust.

Ownership implies entitlement to recall the asset. Life is not like that. When it is released, life cannot be recalled.

When money is withdrawn by recall from the bank, the bank is no longer responsible for the accounting of it.

If by a change of laws, the physician becomes authorized to remove, rather than to protect, treasure and support life, even at the request of the patient, then a fundamental change has occurred in the relationship of the patient to the physician and vice versa.

The erosion of trust would have as profound an impact on the environment of medicine, as deforestation is in the physical world.  It would be like the effect on the financial world of passing a law prohibiting locks on banks.

Legally giving physicians the right to terminate life , no— also imparting the obligation to consider the request of the patient to end his life, (and if in moral disagreement—the obligation to refer the patient to an assessment committee who would determine the appropriateness and the capability of the patient to make “informed consent”) would completely destroy trust.  It could save the government a lot of money.

Such a committee could not be populated other than by persons who agreed that it is acceptable to consider the termination of life as a therapeutic act. Committee members would insist on immunity from responsibility if endorsing the patient’s ‘right” to termination.

Given a change of law, this will become argued as an issue to be determined between the patient and the doctor. Where have we heard that before?

Will this be an unpaid committee? So . . .  someone will be paid to decide whether and when to end another person’s life?  Is this the direction we want to go?

Perhaps we should ask the public,  ‘what would you think, if you saw a sign in a physicians office, declaring something like this:

We endorse choice of the patient,

and we endorse the practice of compassionate

euthanasia with proper documentation.

We can assist you with everything.

This is a government approved

and licensed medical practice.

This is a non-insured service,

the cost is $ _______   plus

(Your life with no recall).

No money? No problem.

We will do it for free but

We will charge your estate.

Your children will pay. . .”

For more information, just ask. . .

Fast-forward—to Circa 2099; “Do you recall a time when it was a felony for a child to pay for someone to terminate a parent so they could get the inheritance?”  

That which we sow, we will reap.

D. Boettger MD

Will physicians be left out of the debate?

-Jennifer Derwey

An article in the Canadian Medical Association Journal warns that physicians "could soon be left in the legal vacuum" with regard to the practice of euthanasia. CMDS is dedicate to giving doctors and dentists a voice in this debate. 

Find out more on how you can be a leading voice on this topic by visiting our educational project website for the CMDS film, The Gift: Living Fully, Dying Naturally, here. 

More from the Ottawa Citizen,

...physicians could soon be left in a legal vacuum if the Supreme Court of Canada rules later this year that laws banning doctor-assisted suicide violate the Canadian Charter of Rights and Freedoms, experts argue in the Canadian Medical Association Journal (CMAJ).

Polls show that support for assisted death is high and growing, said Dr. James Downar, an assistant professor in the division of critical care and palliative care medicine at the University of Toronto.

“The ‘yes-no’ debate is about to become obsolete,” Downar said.

“Physician-assisted death (which covers both physician-assisted suicide involving giving patients a lethal prescription they take themselves, and euthanasia involving administering a lethal injection to the patient) is going to become legal in Canada in the very near future by one means or another” and crucial questions need to be answered, he said, including when does suffering become “intolerable” and how long must it last before doctor-assisted death could be granted? Would psychological or “existential” angst be grounds for seeking a lethal injection?

A Letter to MP Rick Dykstra: In response to Steven Fletcher's News Conference

-Dr. Wes Reimer

Rick,

I happened to catch Mr. Fletcher's news conference today and what I want to pick up on most is his comment that we, as physicians, are basically practicing covert, physician-assisted suicide (PAS) via his "wink wink..." statement.  As a practicing physician in this country and one who deals daily with late stage disease and palliative care, I find Mr. Fletcher's comments misleading of the public, and offensive.

Hearing him speak to this issue today, one would almost think it's flatly illegal to die in Canada!!  It's neither unlawful to live nor to die.  And myself and countless colleagues have the remarkable duty and privilege to care for the dying in a manner that respects their wishes and acknowledges their condition.  

Credits: REUTERS/Chris Wattie

In just the same way that a patient (or their representative) can, at any time, elect to decline any procedure or intervention - even if potentially life saving - the patient also currently has the right to decline any degree of 'medical' management.  At the obvious end stage of illness, many many patients and families decide, in concert w caring physicians, to withdraw all active treatments (eg. feeding tubes, IVs, countless maintenance meds., oxygen etc).  This is not now, nor should it ever be illegal. Some remain in hospital at that point while others prefer a Hospice setting.  The point is, nobody is killing anyone in these everyday scenarios.  Invariably, late stage diseases of all etiologies lead to anorexia and minimal nutrient intake - no winks, no nudges - just the natural, anticipatable sunset of life.  The universal consequence of kidneys and other vital systems shutting down.  "Starvation" would be denying the hungry/thirsty patient proper nutrition when they in fact want it.  That is NOT what we do!  

Now to the use of morphine and related medicines in palliative care.  For centuries, narcotics have been an essential part of compassionate, respectful palliative care.  I thank God for morphine and it's many modern 'cousins' in the realm of controlled substances used appropriately across this country for excellent palliative care every day.  Any increase in rate of such a drug is done because of the often profound escalation of pain in the final days of cancer and other diseases.  Again, no nudging, no winking, and definitely no suicide.  Just good, professional palliative care.  While treating the pain, might the needed dose ever hasten one's passing?  It's certainly possible, but not intentional.  In cases where that has been true, it doesn't change the fact that treating the pain appropriately was the right and compassionate thing to do, in precisely the same way that one may die during necessary heart or limb surgery.  In each case, appropriate, patient-centred care is the intentional act while anticipatable death not infrequently occurs.

Death is an unavoidable, inevitable and entirely natural part of life, and one where physicians, nurses and care givers of all sorts can play a crucial, compassionate role in guiding patients through the process.  Please advocate for the truth on this issue.  That there is no clandestine death club among physicians.   For my part, one of the best things that could arise from the recent resurgence of interest in PAS, is that more funding and emphasis be directed to excellence in palliative care in this country.  As we support and empower caregivers in this art (and it is that), I believe we'll find that the perceived need for and volume of cases relevant to PAS will diminish.

As a conscientious professional in the life science of medicine, I don't ever want to see the day when I and my colleagues are forced by the state to take the life of any patient.  Thank you for receiving this and I trust you can advocate to that end.

Sincerely,
Dr. Wes Reimer
MSc, MD, FCFP

Our Impetus in the Euthanasia Debate

-Lester Liao

Over the past few weeks I have been thinking a lot about the discussion on euthanasia and physician assisted suicide (PAS/E). The topic is so controversial in our society because of the many things that are misunderstood. People have a poor appreciation for what palliative medicine is actually able to do throughout the late-stage disease process, people are swayed by the use of emotionally charged language that paints euthanasia/PAS in a positive light (not unlike using the term “therapeutic” abortion), people misunderstand the whole notion of what a “right” is, and people fundamentally have a flawed grasp on what human life is, both ontologically and practically. This is of course, just a brief sketch of issues I have encountered with colleagues. I am sure that many of us have heard so many other reasons. So what should we do? 

This morning in my daily reading I was reminded of God’s Word through Micah as he addressed Israel, saying, “He has told you, O man, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly with your God?” (Micah 6:8). The Israelites were living arrogantly in a time of wealth during the reigns of the Judean kings Jotham, Ahaz, and Hezekiah (1:1). They oppressed the poor (2:1-2), they sought preaching that would only suit their ears (2:6; 3:11), and they offered meaningless sacrifices to God that were empty rituals in light of their wider actions (6:6-7). In response to all these things, God reminded them what His desire for them had truly been – to do justice and love kindness and walk with Him. 

And yet before God calls them to these actions, He reminds them of their identity and what He had done for them. In 6:3 God rhetorically asks the Israelites, “O my people, what have I done to you? How have I wearied you? Answer me!” In contrast to harming them, He had actually brought them out of Egypt and redeemed them from slavery and saved them from oppressors (6:4-5). He called them to remember who they were as God’s covenantal people and reminded them of what He had done for them. It was only after they recognized this that they would have had the heart to go out and do justice and love kindness. And so it is with us. 

CMDS has been making many efforts to be vocal against euthanasia/PAS. This is a great thing. It is great because it is in the heart of God that we stand for those who are unable to protect themselves and who are being oppressed. God’s call to the Israelites is something we must remember. We must remember who we are as the adopted children of God (consider the National Conference this year from May 1-4!) and remember all that Christ has accomplished for us. For if we forget who we are, we will act without a foundation, forget why we even strive, and grow weary and discouraged. It is when we recognize our identity that we can then begin to organically act out of our nature, namely to love and care for others. 

This is what we should do. Engage colleagues and be vocal. Voice your stance on CMA forums. Do not let this debate go by without standing for justice and kindness to those who are in need of advocacy. For Christ took the initiative to save us in our helpless condition. 

If we find ourselves with little desire to engage in this wider discussion, let us consider our identities and remember who we are in Christ. For we are in a unique position to make contributions to this topic. And while I do not want to confound the fundamentals of being a Christian with being vocal about opposition to euthanasia/PAS, I do believe that when we recognize that God has appointed us to be physicians in Canada, our hearts will begin to stir. As we return to the awesome truth that is the Gospel, let’s pray that we’ll be empowered by the Holy Spirit to let our actions flow from our identity so that we may be light in this world. 

CMDS Executive Director on CBC Radio

-Jennifer Derwey

Listen to CMDS Executive Director, Larry Worthen, point out the risks of legalizing euthanasia in Canada here on CBC's Information Morning, Nova Scotia.

Don't forget to email your comments and questions on this debate during tomorrow's public forum to saintandrews@eastlink.ca.

Upcoming Event: Public Forum on Euthanasia

-Jennifer Derwey

Values and Vision: Is Doctor Assisted Suicide a Right?
MARCH 21 @ 7:00 PM, Halifax, NS

Values and Vision: Is Doctor Assisted Suicide a Right? – A public forum on end of life issues, co-sponsored by the Halifax Shambhala Centre, The Universalist Unitarian Church of Halifax, St. John’s United Church and St. Andrew’s United Church, will be held at St. Andrew’s United Church (Corner of Robie St. and Coburg Rd.) on Friday March 21st at 7pm. Halifax, NS. 

Wanda Morris, Executive Director of Dying with Dignity Canada will be joined by academics, advocates and religious leaders (representing a variety of points of view) for a panel discussion. 

The Christian Medical and Dental Society of Canada's Executive Director, Larry Worthen, will be participating in this event. He will also be interviewed on this topic on Thursday, March 20th on CBC's Information Morning Nova Scotia. You can listen live to that event here on Thursday morning.  

We urge all supporters of the dignity of life to attend. If you cannot attend in person, potential questions for the panelists can be emailed in advance to saintandrews@eastlink.ca

Medicine as Vocation

Medicine as Vocation: Q&A with Daniel Sulmasy

BY JOHN SHORB

How do you view vocation? 

Vocation, simply described, is a calling. It is God who calls us and calls us to be the person we have been created to be, to fulfill God’s plan for us. It is what we in our deepest most central part of ourselves, actually most desire. The match of those two is our vocation, one and the same when our will and God’s will are one for what we should do in life. Everybody in that sense has a vocation. 

There are particular kinds of occupations that are more particularly viewed as ministry. Those are the kinds of traditional ministries of being in the clergy, or being part of the liturgy, being in the choir, being a deacon within a church. But then there are also, at least within the Roman Catholic tradition, particular kinds of works that are classified officially as ministries and those works are what we call the “corporal works of mercy” which come from the list of Christ’s own discourse about where we find him. We find him, we’re told, when we visit the sick, when we clothe the naked, when we feed the hungry. Healthcare is one of those particular kinds of “corporal works of mercy” that is ministerial. When your call in life is to be a minister and your total work is doing that particular work, it is one of those special vocations–vocation with a capital “V”—that is every bit as equivalent to the vocation of being a minister.
From the beginning of recorded history, the roles of priest and doctor were unified, right? The shaman was the healer and certainly it has been significant in the history of Christianity that this work of being a healer has been seen as spiritual kind of work. There is something special about illness and death and those who minister to it and those who are able to heal. It is central to the Christian message, and it is part of the good news. It is part of what Christ announced, and it is part of what he sent the apostles out to do – to heal the sick and preach the good news.

(Full article available here: http://chreader.org/contentPage.aspx?resource_id=551)

URGENT: CMA to Begin Major Consultation on End of Life Care

-Larry Worthen, Executive Director CMDS

The CMA has started a major consultation with CMA members and the general public on end of life care. This includes euthanasia, advanced directives and palliative care. 

This is a signal that we are now in an all Canada debate over whether or not euthanasia should be legalized. The time has come to make our voices heard to protect human life. If we miss this chance it may be too late.  

We strongly recommend that all CMDS members participate in this process by:

If you are a member of the CMA: 

- logging in to https://cmadialogue.ca and registering to be part of the discussion - right away 
- continuing to participate in the discussion to make your views known throughout 
- attending the town halls and breakfast meetings scheduled by the CMA throughout the country for your input 

If you are not a member of the CMA:

- attending the town halls scheduled by the CMA throughout the country for your input 
- making your opinions known to the CMA via correspondence 

All of this input will be taken to the August 2014 meeting of the CMA. It is important that CMDS members get involved with the provincial associations in a formal capacity because only delegates will be able to speak and vote at the August meeting. 

Public meetings and breakfasts are scheduled throughout the country. 

Vancouver (March 24)
Whitehorse (April 16)
Regina (May 7)
Mississauga, Ont. (May 27)
Members in those areas should start now advising their church contacts, friends and family about the need to come out to these sessions. 

IT IS CRITICALLY IMPORTANT THAT WE ALL GET INVOLVED.  The experience of being in Quebec two weeks ago at Mc Gill was very disturbing. The proposed legislation requires that all physicians be involved by participating in referrals, and no institutions - hospitals, nursing homes or even hospices are exempt. Our members are concerned that it will be very difficult to practice in Quebec as a Christian physician. The can spread throughout Canada unless we act now to respond. 

Let's all pray together that this will NOT become legal in our country. 

God bless you 
Larry

Pulse Conference Feedback

-Lester Liao

Last week I attended the Pulse Conference for Christian medical professionals in Toronto.  While it was a short conference spanning Friday evening to Saturday evening, it was certainly an informative one.  The conference was focused on providing spiritual care to patients, considering briefly its merits on the health of patients both in the conventional medical sense and spiritually, and also how it is practically done.  A number of sessions were dedicated to considering what spiritual care is including how to share the Gospel, the ethical implications of such care, the biblical impetus behind such care, and also the effects that such care has on patients.  Following these an afternoon was then set aside to practically engage the community in an effort to practice at least broaching the topic of spiritual care. This was finally followed by a wrap-up session discussing the conference and practicum.

This was only the second time it has ever been run, and a few speakers came up from the United States to share their expertise on the subject.  That being said, the conference is still in its infant stages.  From what I could gather there were some thirty to forty people in attendance at the conference, and they were from various backgrounds including nurses, social workers, physiotherapists, and of course physicians/medical students.  This multidisciplinary involvement was a highlight for me personally, as I was sitting beside a physiotherapist for the conference and found it particularly gratifying to meet a Christian in another medical field seeking to faithfully minister in his setting.  

The conference was certainly an interesting one.  The best way I can characterize it is that it was a primer to spiritual care for Christians.  Given the limited duration of the conference and its young nature, it was difficult to delve very deeply into the subject and the teaching portions were somewhat limited in scope.  Personally I would have liked to see a deeper exploration of the Bible's direction on such matters.  What the conference did provide much of, on the other hand, was testimonials on the impact of spiritual care on patients.  There was also a very heavy emphasis on being practical with what we were learning both during the conference and immediately in the workplace.  These being said I think the conference is a great place for people to begin considering the true merits of spiritual care and to receive guidance on how to do it.  It is also a wonderful place to be encouraged by other believers and to gain an appreciation for the Christian medical community seeking to serve Him in the workplace at large.  It should be noted that things will likely change not insignificantly for the conference in the years ahead, but I would wholeheartedly recommend doctors and medical students to partake in the conference to improve their ability to holistically care for patients and to see Christ glorified in medicine.  May God continue to raise up workers in healthcare that love patients and care for their souls. 

CMDS Executive Director to participate in Physician Conscience Rights discussion

Larry Worthen has been asked to participate for the full hour of the CBC noon hour phone in show Ontario Today on February 25th from 12:00 to 1:00 PM (EST).  The topic of discussion will be on Physician Conscience Rights.

The idea for the show came from a recent conflict between a patient and a doctor in Ottawa who has chosen to exclude contraceptives from his practice. It has come to light that three physicians in Ottawa have taken this step. Ottawa Clinic Doctors' Refusal

CMDS supports the right of physicians to determine their response to patient needs based on their medical judgement, moral concerns and religious beliefs. 

This will be the substance of the hour long phone in show. An activist group that publicized this issue will be given a prerecorded interview, then the rest of the hour will be taken up with people phoning in.

Please pray for Larry as he takes on this endeavor to uphold the conscience rights of physicians and medical professionals. You may also wish to listen in to the program, or even call.

We urge you to call in to give your opinion. The toll free number to call in is: 1-888-817-8995.

Larry Worthen BA, MA (Th.), LLB
Executive Director
Christian Medical and Dental Society of Canada
Cell: (902) 880-2495

"Quebecers call out to the world to stop Euthanasia Bill 52"

From CoalitionMD.org, 

MONTREAL, Feb. 9, 2014 /CNW Telbec/ - As Quebec prepares to become the first province in Canada and the first place in the Americas to enact a law permitting euthanasia without a referendum, Quebecers call out to the world to ask their help to influence the government of Quebec not to  pass the legislation. In this video different citizens from a cross section of Quebec society share their personal stories and explain the dangers and abuses that would follow if such a law is enacted.
Nadine who is currently 16 years old and has conquered an aggressive form of leukemia including a harrowing experience with a bone marrow transplant, describes how she would have refused lifesaving chemotherapy when she was only 14 years old if the proposed law was in force. The law would allow 14 year olds to refuse treatment without the consent of their parents. Thankfully the law was not in place and Nadine is alive and well. Her mother Claude testifies to the importance of family and love in supporting young people through the most vulnerable time of their lives.

"Mixing medicine and religion"

From the Duke Chronicle Herald, 

Interdisciplinarity, usually an ill-defined buzzword at Duke, has found a concrete purpose in a partnership between the Divinity School and the School of Medicine. The jointly launched Theology, Medicine and Culture initiative seeks to "deepen theological reflection, church practice, and community formation related to the human experience of illness, suffering and death."

Founded in 2013, TMC offers Divinity students the option of pursuing a certificate program and medical students the opportunity to attain a dual degree. Ray Barfield, the program’s director, stresses TMC’s role in promoting holistic medicine, noting that, “medicine is failing, and one of the main reasons is because the only language it has access to is the incredibly efficient and devastatingly limited language of biology.”

By broadening doctors’ vocabularies, the joint program seeks to address two common criticisms of health care delivery: the inability of many doctors to communicate effectively with patients and a lack of cultural competency among health care providers.

Doctors who coolly treat their patients as test subjects or who fail to connect with them can sow mistrust and, in some cases, worsen health outcomes. Cultural tone-deafness—doctors failing to understand a patient’s background—can cause patients to remain wary of their health care providers and lead to poor treatment.

It seems plausible that theological study would help doctors better communicate with and understand the beliefs of their Christian patients. [Read more: http://www.dukechronicle.com/articles/2014/02/05/mixing-medicine-and-religion]